Provider Demographics
NPI:1326749656
Name:PIERRE, JIMPER KENDAL (OWNER)
Entity Type:Individual
Prefix:
First Name:JIMPER KENDAL
Middle Name:
Last Name:PIERRE
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WESTINGHOUSE PLZ STE A206
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-2079
Mailing Address - Country:US
Mailing Address - Phone:617-991-0498
Mailing Address - Fax:
Practice Address - Street 1:1 WESTINGHOUSE PLZ STE A206
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-2079
Practice Address - Country:US
Practice Address - Phone:617-991-0498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver